Fad Diets Versus Prescribed Diets for Kidney Disease

Juice detoxes, intermittent fasting, and the cabbage soup diet: What do these have in common? They're all fad diets. What is a fad diet, and should people with kidney disease follow them? Kidney dietitian Amanda Hayes and Jane Demise, a stage five kidney disease warrior, answer these questions and more. 

Differences Between Fad Diets and Prescribed Diets

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A fad diet is most easily identified by claims of quick results. 

"Fad diets typically share 'secret hacks' to weight loss," said Hayes. “They tend to be restrictive, eliminating whole food groups while elevating other foods as ‘magical’ treatments."

A prescribed diet is prescribed by a healthcare practitioner to help people manage and support their long-term health. 

"Prescription diets help manage medical conditions. For example, someone with later-stage kidney disease may need a lower potassium diet. Someone on dialysis may need a high protein diet because protein is removed by the dialysis machine," Hayes said. "Prescribed diets, like plant-based diets, are not quick fixes. They are life."

Plant-based diets include:

• The Mediterranean diet: Consists mainly of cereals, grains, vegetables, beans, fruits, and nuts and moderate amounts of fish, cheese, olive oil, yogurt, and little red meat.
• The DASH diet: Typically recommended to people with high blood pressure. It is full of fruits, vegetables, low-fat dairy foods, whole grains, poultry, and nuts. This diet limits salt, sugar, red meat, high-saturated fat, cholesterol, and trans fat.
• The MIND diet: Combines the Mediterranean diet and the DASH diet to create a diet that prioritizes brain health with green leafy vegetables, berries, nuts, olive oil, whole grains, fish, beans, and poultry. 

If a healthcare practitioner recommends a specific diet, ask for the long-term study data or a referral to a kidney dietitian to ensure it is medically backed and suitable for you. 

"It can get tricky to differentiate prescribed diets from fad diets because some fad diets share their research," said Hayes. "The quality of the study matters. They could be too small, poorly designed, or theoretical."

Learn more about plant-based diets.

Dangers of Fad Diets

Can following a fad diet be harmful? According to Hayes, the answer is–yes.

"People with kidney disease are vulnerable to malnutrition. If you limit an entire food group, you also limit a whole food group's nutrients," Hayes said. "Extreme weight loss or gain in people with stage three to five population is also associated with a higher likelihood of progressing to dialysis."

These diets can also lead to nutrient imbalances and diet burnout.

"Getting the correct nutrients is crucial. For example, eating only cabbage soup could lead to high potassium. High protein diets like Paleo and Atkins can be especially harmful for those with pre-dialysis kidney disease stages," said Hayes. "In my experience, these diets are unsustainable and often lead to burnout or disordered eating."

For Jane, first diagnosed with kidney disease stage 3 in 2006, long-term fad diets resulted in metabolism issues. 

"I've tried multiple fad diets, including the cabbage soup diet that was popular in the 1980s. You had one regular meal and cabbage soup twice a day for that diet. It didn't help me lose weight, and it was high in sodium," Jane said. "Years later, I asked a specialist why I was struggling to lose weight. Fad dieting messed my metabolism up."

Learn more about diet myths.

Practicing Prescribed Diets

By 2017, Jane's kidney disease had progressed to stage 4. She turned to a kidney dietitian for help. 

"They told me I wasn't eating enough or consuming enough good calories. I was close to malnutrition because I was limiting the wrong foods," said Jane. "My kidney dietitian was the first person to look at me as a whole person and help me devise a plan that helped me lose weight while getting the nutrition I need to stay healthy and protect my kidneys."

Within a year of working with a kidney dietitian, Jane lost 50 pounds and has since maintained most of this weight loss. Why was it successful this time?

"Diets usually go hand in hand with guilt and self-punishment. This time, I wasn't changing my diet only to lose weight. I was doing it to feel better and stay healthy. I switched my mindset from dieting to changing my lifestyle," Jane said. "I believe this lifestyle is how I've avoided dialysis for so long."

Proper motivation and mindset are key. 

"Are you making these diet choices because you are worthy of respect and care or is it guilt-driven? Shame doesn't lead to long-term behavioral changes," Hayes said. "Small changes, flexibility, and consistency do."

And remember, kidney diets are not only about restricting food.

"A kidney diet should also be about adding more healthy, plant-based foods," said Hayes. "Having the mentality of adding as opposed to removing helps preserve the joy of eating and decreases chances of burnout."

Find kidney disease-friendly recipes or superfoods to add to your plate.